Telehealth cart that supports a removable tablet with seamless audio/video switching

ABSTRACT

A two-way audiovisual communication device with multiple audio and video subsystems. In one embodiment, the device includes a wheeled cart that supports a dock for a tablet computing device that includes a tablet camera, a tablet display, and a tablet microphone. The device also includes a cart camera, a cart speaker, and a cart microphone. The device may be coupled to a network and accessible to other devices on the network to allow a two-way audiovisual session to take place between remote parties. The device may operate in two modes: In a first mode, the tablet is mated with the dock and the remote device receives video from the pan-tilt-zoom camera and audio from the cart microphone. In a second mode, the tablet is removed from the dock and the remote device receives video from the tablet camera and audio from the tablet microphone. In both modes, the tablet monitor displays video from the remote device.

BACKGROUND

Telemedicine, also referred to as telehealth, generally refers to theuse of technology to enable physicians or other healthcare providers toexamine and treat or recommend treatment for a remotely located patient.Although telemedicine can be practiced using technology as simple as atelephone, the telemedicine solution market today includes devices andsoftware having a wide range of sophistication.

The range of solutions generally intends to satisfy the functional andeconomic requirements of telemedicine encounters in different types ofsettings with varying levels of acuity. For example, smartphones,tablets, or laptop computers with basic audiovisual capabilities may besufficient for a patient to consult with their doctor on treating a coldor behavioral health issues. These types of devices, however, may beinsufficient in a higher acuity setting such as a hospital emergencydepartment, intensive care unit, or specialty clinic, where the remotephysician may require more capable video or imaging devices and/or theability to monitor data from peripheral medical devices in real time.Other settings where telemedicine is practiced may present other uniquerequirements. Thus, the telemedicine solution market is replete withdisparate devices and software that seek to satisfy the variedrequirements of many different telehealth encounter settings.

SUMMARY

It would be desirable to provide a telemedicine device with broadersuitability by integrating the simplicity and familiarity of asmartphone, tablet, or laptop, with a more sophisticated telemedicinesystem that facilitates use in higher-acuity settings and includesenhanced audio and video systems as well as the ability to connect to avariety of medical peripherals.

To achieve these ends, one aspect of the disclosure includes atelemedicine system comprising a cart that supports a dock and a cartcamera. The dock is adapted to receive a tablet device that includes atablet camera. The system also includes a remote device communicativelycoupled to the tablet via a network. The remote device includes adisplay device that displays video captured by the cart camera when thetablet is coupled to the dock and displays video captured by the tabletcamera when the handheld computing device is decoupled from the dock.The system may display video from the remote station on the tabletdisplay when then tablet is docked and when it is undocked.

BRIEF SUMMARY OF THE DRAWINGS

FIG. 1 illustrates an example of a telemedicine system in accordancewith the disclosure.

FIG. 2 illustrates an example of a telemedicine system in accordancewith the disclosure in use during a session with a patient.

FIG. 3 illustrates an example of a telemedicine system in accordancewith the disclosure with the tablet device removed from dock.

FIG. 4 is a detailed view of an example of a dock in accordance with thedisclosure.

FIG. 5 is a block electrical diagram of a telemedicine system inaccordance with the disclosure.

DETAILED DESCRIPTION

The following disclosure includes a telemedicine system including a cartthat supports a dock and audio and video hardware. The dock isconfigured to receive a tablet computing device that can connect to andestablish a two-way audiovisual session with a remote station. When thetablet is docked, the tablet is connected to the cart's audio and videohardware and the tablet may stream audio and video from the cart A/Vhardware to the remote station. When the tablet is undocked, the tabletmay stream audio and video from the tablet's onboard A/V hardware to theremote station. The cart may also include peripheral ports that allowthe tablet to stream peripheral data to the remote station when thetablet is docked.

With reference to the drawings, FIG. 1 illustrates a front view of anexemplary telemedicine cart 10 that forms part of a telemedicine systemin accordance with the disclosure. The cart 10 may support a dock 12that can be mated with a tablet computing device 14. The tabletcomputing device 14 may include at least one built-in display 16, camera18, speaker 20, and microphone (not shown). The cart 10 may also supporta cart camera 22 and a cart audio module 24, which may include both aspeaker and a microphone (not shown). The cart audio module 24 may beincorporated as a single device as illustrated in FIG. 1 or as separatespeaker and microphone modules.

The cart 10 may include a wheeled base 26 that supports a housing 28that encloses a battery 30 and/or other electrical components. The cart10 may also support a drawer 32 that can be used to store one or moremedical peripherals or other accessories that may be needed during asession. FIG. 1 illustrates an exemplary medical peripheral 34 restingon a work surface 36 above the drawer 32 and coupled to the cart 10 viaa peripheral port 38. The drawer 32 may include a lock 40 to preventremoval of items stored therein. Examples of medical peripherals thatmay be connected to the peripheral port include a stethoscope, otoscope,dermal camera, exam camera, vitals monitor, portable ultrasound, etc.

The tablet computing device 14 executes an application that allows aremote device (not shown) to establish a two-way audiovisual sessionwith the tablet. The remote device executes a similar application tocommunicate with the tablet. The application may be a telemedicineapplication that allows for two-way audiovisual communication, remotecamera control, access to medical records and imagery, and otherfeatures that facilitate a remote consultation between a healthcareprovider and a patient. The remote device could be a laptop or desktopcomputer, tablet, smartphone, videoconferencing terminal, or any otherdevice suitable for conducting a two-way audiovisual communicationsession. During the session, the tablet display 16 displays videocaptured by a camera of the remote device. Typically, during atelemedicine session, a physician uses the remote device to consult witha patient located in the vicinity of the cart 10. In this scenario, andas illustrated in FIG. 1, the physicians image, captured by the cameraof the remote device, may be displayed on the tablet display 16 so thepatient can see the physician. While the tablet is mated with the dock12, the cart camera 22 is used to capture video of the patient, which iscommunicated to and displayed at the remote device so the physician cansee the patient. Similarly, while the tablet 10 is mated with the dock12, audio captured by a microphone of the cart audio module 24 may bestreamed to and reproduced by a speaker of the remote device, whileaudio captured by a microphone of the remote device is streamed to andreproduced by a speaker of the cart audio module 24. In this way, theremote physician and the patient in the vicinity of the cart 10 can bothsee and hear each other.

FIG. 2 illustrates a rear view of an exemplary telemedicine cart 10 inaccordance with the disclosure. One or both of the dock 12 and the cartcamera 22 may be supported by an upper column 42 connected to the base26 via a lower column 44. The drawer 32 and the work surface 36 may alsobe coupled to the lower column 44. The height of either or both theupper and lower columns 42, 44 may be adjustable to allow the height ofthe cart camera 22, the dock 12, the work surface 36, and the drawer 32to be adjusted. By way of example, the height of the cart camera 22 andthe dock 12 may be adjustable in a range of two feet to seven feet. Thisallows the height of the tablet 14 and the cart camera 22 to be adjustedto suit a variety of situations in which the patient may be standing,seated, or lying on a gurney, patient bed, or floor. The dock 12 may becoupled to the upper column 42 via a hinge 46 that allows a tilt angleof the dock and the tablet to be adjusted. By way of example, the dock12 may be tilted in a range of +/−60 degrees about a line drawn parallelto the floor. FIG. 2 additionally illustrates several peripheral ports38 on the side of the drawer 32 that can be used to attach a variety ofmedical or other peripheral devices to the telemedicine system.

FIG. 3 illustrates a view of an exemplary telemedicine cart 10 with thetablet 14 removed from the dock 12. As described above with respect toFIGS. 1 and 2, when the tablet 14 is mated with the dock 12, audio andvideo of the patient are captured by the cart camera and a microphone ofthe cart audio module 24, and physician audio from the remote station isreproduced by a speaker of the cart audio module 24. When the tablet 14is removed from the dock 12, the session continues uninterrupted, butthe audiovisual session switches automatically to the audio and videosubsystems of the tablet 14. Thus, while the tablet 14 is undocked, theremote device receives video of the patient from the tablet camera 18and audio of the patient from the tablet microphone (not shown).Similarly, audio from the remote device is reproduced by the tabletspeaker 20. This allows a patient, or someone in the vicinity of thecart 10, to remove the tablet 14 from the dock 12 during a session andcontinue the session with the tablet 14 in his or her hands, whilemoving around or to another room, and/or at a desk or in a chair awayfrom the cart 10 itself. In general, the system enables a person in thevicinity of the cart 10 to carry on a session wherever the tablet 14 canbe moved to and its network connection maintained. Alternatively, thesession can be initiated while the tablet 14 is not in the dock 12, andthe tablet 14 can later be mated with the dock 12 during the session toenable the remote physician to access audio and video from the cartcamera 22 and cart audio module 24, as well as images, audio, and/orother data from one or more medical peripherals 34 coupled to the cart10. Regardless of the location of the tablet 14 when the session begins,the tablet 14 can be docked or undocked as desired to leverage theportability of the tablet 14 or the enhanced audiovisual and peripheralcapabilities of the cart 10 as needed, without interrupting the existingsession with the remote physician.

FIG. 4 illustrates a detailed view of an example of the dock 12. Thedock 12 may be coupled to the upper column 42 via a hinge (not shown) toallow the dock 12 to be tilted up and down, as described above. Thehinge may also allow the dock 12 to be panned to the left and right. Thedock 12 may include a frame 46 and upper 48 and lower 50 horizontalchannel guides adapted to receive and secure the tablet in the dock 12.The dock may also include a vertical stop 52 coupled to one end of theframe 46 to guide and position the tablet when it is slid into the dock12. The vertical stop 52 may include electrical contacts 54 adapted toengage electrical contacts on the tablet. For example, the vertical stop52 may include a data plug and a power plug that mate with a data jackand power jack, respectively, on the tablet when the tablet is seated inthe dock 12. The dock 12 may additionally include a retractable tabmechanism 56 that can be retracted to allow the tablet to be slid in andout of the dock 12 or extended to prevent removal of the tablet while itis seated in the dock 12. The retractable tab 56 may be extended orretracted by actuating a key lock 58 mounted on the frame 46 of the dock12. Those skilled in the art will recognize that the location of anypower and/or data plugs on the dock 12 will depend on the location oftheir corresponding jacks on the housing of the tablet.

FIG. 5 is an electrical block diagram of the various components of anexemplary telemedicine cart in accordance with the disclosure. Thesystem may include a tablet computing device 14, a cart camera 22, and acart audio module 24, which may include a microphone 60 and a speaker62. An example of a tablet suitable for use in the described system isthe SURFACE PRO tablet marketed by the MICROSOFT CORP. of Redmond, Wash.The cart camera 22 may take the form of a pan-tilt-zoom or (“PTZ”)camera. An example of a PTZ camera suitable for use in the describedsystem is the TELYCAM Model TLC300 marketed by TELECAM TECHNOLOGY, CO.An example of a suitable cart speaker and microphone module 24 is thePHOENIX AUDIO DUET-PCS Desktop Speakerphone. Although the microphone 60and speaker 62 are illustrated as incorporated into a single audiomodule 24, it is to be appreciated that the microphone 60 and speaker 62may be embodied as separate components. The cart may also include one ormore universal serial bus (“USB”) peripheral ports 38 that allow for theconnection of peripheral medical devices or other external devices tothe system. Each of the tablet 14, the cart camera 22, the cart audiomodule 24, and the USB peripheral ports 38 may be coupled to andcommunicate with each other over a USB interface via a USB hub 64.

Depending on the capabilities of the cart camera 22, the cart camera mayalso include a control interface 66. The camera control interface may beimplemented using a serial data interface such as RS-232 and allow forenhanced camera control. In order to enable these enhanced cameracontrols, the cart may include a USB/RS-232 converter 68 interposedbetween the control interface 66 and the USB hub module via USB. Thisallows enhanced camera controls to flow from the tablet 14 to the cameracontrol interface 66.

The cart may additionally include a battery 30 coupled to a power supply70 that includes a battery charger 72. The power supply 70 may includean AC cord and/or plug 74 that receives line voltage from a standardwall socket to power the cart and/or charge the cart battery 30. Thebattery 30 allows the cart to be wheeled to and used at a location forhours or days where no wall socket is available. Some components, suchas the cart camera 22, the USB hub 64, and the tablet 14, may supportdedicated connections to the power supply 70, illustrated with dottedlines in FIG. 5. Other components, such as the cart audio module 24, theUSB/RS-232 converter 68, and the peripheral ports 38, may be poweredusing power drawn from other components via their data (e.g., USB)connections, illustrated with solid lines in FIG. 5. It is to beappreciated the components shown as having or not having dedicated powerconnections is only illustrative and any combination, including all ornone, of the components may use (or not use) a dedicated powerconnection.

The cart may leverage the tablet's 14 own wireless network adapter (notshown) to connect to the Internet. For example, the tablet 14establishes a connection with the Internet via its own WiFi or cellularadapter (or both) and the application running on the tablet communicateswith the audio, video, and peripheral hardware of the cart to stream theaudio, video, and peripheral data therefrom over the network connectionto the remote station. It is to be appreciated that the cart couldalternatively or additionally have onboard wired and/or wireless networkadapters that could be accessed by the application executing on thetablet to communicate with the remote station via the Internet.

The tablet may be configured to remain active and executing theapplication at all times. This ensures that the tablet, the cart, andthe system in general are available to accept an incoming request toestablish a telemedicine session at any time, which is preferable in amedical setting where emergent situations are common.

During the telemedicine session, the application on the tablet isconfigured to detect whether a cart camera, cart microphone, and cartspeaker are available to stream audio and video data to the tablet viathe USB interface. If so, the application streams the audio and videodata from the cart audio and video hardware to the remote station viathe network connection. Likewise, in this case, the application willreproduce audio received from the remote station via the cart speaker.On the other hand, if the application cannot receive audio and videofrom the cart audio/video hardware, the tablet will stream audio andvideo data from the tablet's onboard camera and microphone to the remotestation. Likewise, in this case, the tablet will reproduce audioreceived from the remote station via the tablet's onboard speaker. Ineither case, video received from the remote station is displayed on thetablet monitor.

In one embodiment, the switching of audio and video sources by theapplication may be implemented by setting the default audio and videohardware in the tablet operating system. For example, the applicationmay periodically poll or continuously listen to the tablet's USBinterface for the presence of certain devices indicative of the tabletbeing docked. That presence of one or more, or any combination of, thefollowing devices may be used by the application to determine whetherthe tablet is docked: battery charger 72, power supply 70, cart camera22, cart audio module 24, peripheral ports 38, or any other suitabledevice.

When the application senses that the tablet is docked, it may beconfigured to set the default microphone and speaker in the tabletoperating system to the microphone and speaker of the cart audio module24. Similarly, the application may be configured to set the defaultcamera in the tablet operating system to the cart camera 22. In oneembodiment, the application may force (or repeatedly set) the cart audiomodule as the default speaker and microphone to prevent the operatingsystem from selecting another external speaker/microphone system (suchas a headset) that may be plugged into the tablet while the tablet isdocked.

When the application senses that the tablet is undocked, the applicationmay be configured to allow the tablet operating system to set thedefault microphone and speaker. In this way, when the tablet isundocked, the audio may be captured and reproduced by the tablet'sbuilt-in microphone and speaker, or an external microphone and speakerthat the user may choose to plug into the tablet (e.g., a headsetmicrophone and speaker set). Similarly, when the tablet is undocked, theapplication may allow the operating system to set the default camera,which may be the tablet's built-in camera. If the tablet includesmultiple on-board cameras (such as a forward-facing camera and arear-facing camera), the application may alert the correspondingapplication at the remote device to the presence of multiple cameras,which may then provide the user of the remote device with the option toselect to display video from either or both of the tablet cameras.

As described above, while the tablet is docked, the application may setthe default camera to the cart camera. However, if the applicationdetects the presence of additional cameras or other devices connected tothe peripheral ports 38 on the cart, the application running on thetablet may alert the application running on the remote device of thepresence of the additional cameras or other devices. In this scenario,the application at the remote device may provide the user of the remotedevice with the option to select to display video, image, or other datafrom one or more of the peripheral devices. The user's selection maythen be communicated back to the application running on the tablet tocontrol which device's video or other data is streamed back to theremote device. The selected video or other data may be displayed insteadof or in addition to (as a multi-tiled or split screen display) videofrom the cart camera.

As discussed above, regardless of the state of the tablet (i.e., dockedor undocked) when the session begins, the tablet can be docked orundocked any number of times thereafter and, each time, the applicationwill automatically switch to streaming audio and video to and from thecart hardware or the tablet's onboard audio and video hardwareaccordingly such that the audio video session may continueuninterrupted.

In an alternative embodiment, the cart could additionally include one ormore display devices that could be used, alternatively or additionally,to display video received from the remote station. In this embodiment,as with the embodiment described above, either the tablet display or thecart display may be used to display the video from the remote stationdepending on whether the tablet is seated in the dock.

During the session, the application may be configured to read anddisplay and the tablet display one or more physiological parametersreceived from one or more medical monitoring device connected to thecart's peripheral ports. In one embodiment, the cart may be placed in aclinic where a patient is scheduled to have a consultation with a remotephysician. In this case, a nurse or medical assistant may capturepatient vitals, such as temperature, heart rate, blood pressure, andblood oxygen saturation using one or more peripheral monitoring devicesconnected to the cart. The patient vitals may be displayed on the tabletdisplay for verification by the nurse. When the nurse is satisfied thatthe patient vitals are accurate, he or she may tap a button on thetablet display or issue a verbal command that instructs the applicationto transmit a message to the remote device including the patient vitalsdata and an alert that the patient is ready for the remote consultationto begin. The remote physician may then initiate the two-way audiovisualsession with the cart from the remote device.

Additionally, as will be appreciated by one of ordinary skill in theart, principles of the present disclosure may be reflected in a computerprogram product on a computer-readable storage medium havingcomputer-readable program code embodied in the storage medium, thecomputer-readable program code executable by a processor. Any tangible,non-transitory computer-readable storage medium may be utilized,including magnetic storage devices (hard disks, floppy disks, and thelike), optical storage devices (CD-ROMs, DVDs, Blu-Ray discs, and thelike), flash memory, and/or the like. These computer programinstructions may be loaded onto a general purpose computer, specialpurpose computer, or other programmable data processing apparatus toproduce a machine, such that the instructions that execute on thecomputer or other programmable data processing apparatus create meansfor implementing the functions specified. These computer programinstructions may also be stored in a computer-readable memory that candirect a computer or other programmable data processing apparatus tofunction in a particular manner, such that the instructions stored inthe computer-readable memory produce an article of manufacture,including implementing means that implement the function specified. Thecomputer program instructions may also be loaded onto a computer orother programmable data processing apparatus to cause a series ofoperational steps to be performed on the computer or other programmableapparatus to produce a computer-implemented process, such that theinstructions that execute on the computer or other programmableapparatus provide steps for implementing the functions specified.

While the principles of this disclosure have been shown in variousembodiments, many modifications of structure, arrangements, proportions,elements, materials, and components, which are particularly adapted fora specific environment and operating requirements, may be used withoutdeparting from the principles and scope of this disclosure. These andother changes or modifications are intended to be included within thescope of the present disclosure.

The foregoing specification has been described with reference to variousembodiments. However, one of ordinary skill in the art will appreciatethat various modifications and changes can be made without departingfrom the scope of the present disclosure. Accordingly, this disclosureis to be regarded in an illustrative rather than a restrictive sense,and all such modifications are intended to be included within the scopethereof. Likewise, benefits, other advantages, and solutions to problemshave been described above with regard to various embodiments. However,benefits, advantages, solutions to problems, and any element(s) that maycause any benefit, advantage, or solution to occur or become morepronounced are not to be construed as a critical, a required, or anessential feature or element. As used herein, the terms “comprises,”“comprising,” and any other variation thereof, are intended to cover anon-exclusive inclusion, such that a process, a method, an article, oran apparatus that comprises a list of elements does not include onlythose elements but may include other elements not expressly listed orinherent to such process, method, system, article, or apparatus. Also,as used herein, the terms “coupled,” “coupling,” and any other variationthereof are intended to cover a physical connection, an electricalconnection, a magnetic connection, an optical connection, acommunicative connection, a functional connection, and/or any otherconnection.

While certain exemplary embodiments have been described and shown in theaccompanying drawings, it is to be understood that such embodiments aremerely illustrative and not restrictive on the broader disclosure, andthat this disclosure not be limited to the specific constructions andarrangements shown and described, since various other modifications mayoccur to those ordinarily skilled in the art.

What is claimed is:
 1. A telemedicine system comprising: a cart thatsupports a dock and a cart camera, the dock adapted to receive a tabletdevice that includes a tablet camera; and a remote devicecommunicatively coupled to the tablet via a network, the remote deviceincluding a display device that displays video received from the tabletdevice during a communication session, wherein the video received fromthe tablet device is automatically switched between video from the cartcamera and video from the tablet camera depending on whether the tabletis coupled to the dock such that the display device displays videocaptured by the cart camera when the tablet is coupled to the dock anddisplays video captured by the tablet camera when the handheld computingdevice is decoupled from the dock and the cart camera, and wherein thetablet displays a button that, when selected, causes the tablet totransmit a message to the remote device including an alert that apatient is ready for a remote consultation to begin.
 2. The system ofclaim 1, wherein the dock includes a plurality of electrical contactsthat mate with the tablet when the tablet device is coupled to the dock.3. The system of claim 2, wherein the cart further includes a powersystem that is coupled to tablet via one or more of the plurality ofelectrical contacts when the tablet is coupled to the dock.
 4. Thesystem of claim 3, wherein the power system includes a battery.
 5. Thesystem of claim 3, wherein the power system includes a battery charger.6. The system of claim 3, wherein the power system includes an AC powerplug attached to the cart via a power cord.
 7. The system of claim 2,wherein the cart camera is coupled to the tablet via one or more of theplurality of electrical contacts when the tablet is coupled to the dock.8. The system of claim 2, wherein the cart supports a cart speaker and acart microphone, the cart speaker reproduces audio captured by amicrophone of the remote device and the remote device includes a speakerthat reproduces audio captured by the cart microphone.
 9. The system ofclaim 8, wherein the cart speaker and the cart microphone are coupled tothe tablet via one or more of the plurality of electrical contacts whenthe tablet is coupled to the dock.
 10. The system of claim 8, whereinthe tablet includes a tablet speaker and a tablet microphone, wherein,when the tablet is decoupled from the dock, the tablet speakerreproduces audio captured by a microphone of the remote device and theremote device includes a speaker that reproduces audio captured by thetablet microphone.
 11. The system of claim 1, wherein the tablet deviceincludes a display device, the remote device includes a camera, and thetablet display device displays video captured by the remote devicecamera.
 12. The system of claim 11, wherein the tablet display device isa touchscreen.
 13. The system of claim 12, wherein the tablet displaydevice displays one or more physiological values received via a medicalperipheral coupled to the tablet.
 14. The system of claim 1, wherein thecart camera is a pan-tilt-zoom camera and can be controlled by a userinput via the remote device.
 15. The system of claim 1, wherein the dockincludes a latching mechanism for securing the tablet when coupled tothe dock.
 16. The system of claim 15, wherein the latch includes a lock.17. The system of claim 1, wherein the cart supports a work surface. 18.The system of claim 1, wherein the cart supports a drawer.
 19. Thesystem of claim 1, wherein the height of at least one of the dock andthe cart camera is adjustable.
 20. The system of claim 1, wherein thecart includes a peripheral communication port that can be coupled toperipheral device and the tablet via a communication bus.